Charles Sharpe has been a teacher, a residential child care worker, a child care consultant and is a psychodynamic psychotherapist. He is the presiding editor of the goodenoughcaring Journal. He lives in Totnes and sometimes in Edinburgh.

Acceptance is not a passive thing : a consideration of some aspects of Clare Winnicott’s influence on residential child care

For many people the name Winnicott is first associated with Donald Winnicott, the renowned paediatrician and psychoanalyst, who during the 1950s and 1960s had great influence in the field of child development theory. Through his work, his writing and his radio broadcasts he informed a generation of parents and others who were charged with the care and education of children. His ideas remain strong currency in the child care field.

In recent years, thanks in no small measure to the research and the writing of Joel Kanter, the original and quietly influential work of Winnicott’s wife, Clare has rightly emerged from the shadow cast by her husband’s works. As a social worker with families and children, as a psychiatric social worker, a social work theoretician, for her role in the development of social work as a profession, as a supportive advisor to residential child care establishments and as a leader in the development of social work education, she was a pioneering figure. She was all this in addition to being a support to Donald Winnicott in his work and was a creative, imaginative and generous aide to his theoretical thinking.

In this article, following a brief account of her life, I give examples, drawn from her time in Oxfordshire during the second world war, of the work and thoughts of Clare Britton, later Clare Winnicott, which I believe characterise her influence in the field of residential child care. Two vignettes of Clare’s working life during that time, provide sources for my own somewhat limited interpretation of Clare’s ideas and I offer a view of the therapeutic possibilities which I believe she opened for those working in residential child care. To be sure my article is in the nature of a short introductory piece. Readers who would wish to find richer and deeper sources about her life and work are directed to Joel Kanter’s website Clare Winnicott : Life and Work which carries many superb essays and papers about and by Clare. Another most important : source of information for this article has been the script of an interview Clare had with Alan Cohen in 1980. This is one of a series of twenty- six interviews scripts with architects of the social work discipline as it searched for its function and boundaries during and after the last war. Many of the interviewees are women and the archive gives a distinct impression that social work was a profession in which, perhaps more than in others, women became powerful figures as leaders and as the educators and practitioners. Women it seemed were developing, maintaining, and driving the social work engine. The archive of Alan Cohen’s interviews which has been prepared over a number of years was made made fully available in November 2013 and can now be read at the WISEarchive site at WISEarchive and at the Warwick University Library’s Modern Record Centre.

The scripts of these interviews are available as text and as aural recordings. In my view they are not to be missed by any serious student of social work and the professions related to it.

Clare Britton / Winnicott

Elsie Clare Nimmo Britton was born to Elsie and James Britton in 1906 in Scarborough, Yorkshire where her father was a minister of the Baptist church. She was the eldest of a family of four and the big sister of Jimmy, Karl and Liz. Her mother Elsie was also the daughter of a minister and before she married Clare’s father she trained as a teacher as Clare was later to do. In 1912 Clare’s family moved to London where her father had a ministry in Clapham and then in 1922, the family moved to Southend on Sea where her father had charge of the Avenue Baptist Church.

Clare seemed to be impressed by her father’s shepherding of his flock for she was involved in many of the groups and associations which were formed with the church at their core. These activities afforded the teenage Clare the experience of and involvement in, a number of the church’s community groups. One project with which she was involved was the church’s provision of short holidays by the seaside to children from the poor areas of the east end of London (Kanter,2004). After attending the High School in Southend, Clare went to Birmingham to train as a teacher. She never formally took up a teaching role once she had qualified she but spent much of her time as an enthusiastic and energetic youth club leader in Nottingham and in Norwich. Holman (2013) suggests that the Clare ‘had clearly taken on her parents concern for underprivileged families” and that this ‘remained with her.’

In 1937 Clare enrolled as a student on the one year social science course at the London School of Economics an institution which over the years was to play a significant part in her life for in future years she was to become an important figure in the life of students and in the development of social work there. When she completed her course Clare was appointed to a post as a club organiser for unemployed young men in Merthyr Tydfil which since the depression had been acknowledged as one of the most deprived areas in the United Kingdom and the memory of the poverty she observed their stayed with her throughout her life (Kanter,2004).

Clare’s sisters thought that during the 1930s Clare was a socially lively and occasionally wild woman. She was always a supporter and admirer of her father’s work, though she began to show signs of the independent thinker who would develop over the coming years and she increasingly eschewed the Christian stance, eventually stating she was an atheist and she took up a socialist political position (Holman, 2013).

In 1940, during the first year of the last war, Clare enrolled once more at the LSE to follow a course on mental health and so she became one of the first Psychiatric Social Workers. Although opportunities to work in child guidance clinics were open to her, Clare opted do her social work in the community with evacuation schemes in Reading and the Midlands which had been set up to help children who were being evacuated to less populated areas to safeguard them from the dangers of the bombing going in the larger cities where they lived. As an aside Bob Holman has suggested less that it was the bitz which set up the child welfare system in England and Wales because so many children were suffering the emotional stress of being separated from their families (Holman, 2010).

In 1942 while she was working for the Midlands regional health authority she was dispatched to Oxfordshire where her responsibilities were to support a group of hostels for evacuated children who could not be placed with families. The children placed in these hostels – more than 200 were set up throughout England and Wales – were ‘difficult’ children designated by the Ministry of Health as those who “through of behaviour and temperament could not be suitably billeted but needed special care and supervision’(Holman,2013). Mention might also be made that a significant number of families approached by billeting officers to look after were reluctant to take the children in, an issue the novelist Evelyn Waugh satirizes in Put Out More Flags he recounts the exploits of a family of siblingsby the name ‘the Connollys’(Waugh,1942).

Through her work with these hostels Clare met and worked with her future husband the psychiatrist, paediatrician and psychoanalyst, Donald Winnicott who had been asked to visit and offer support to one of the hostels for one day a week. Winnicott seemed lost in these surroundings and struggled to find a purpose and there can be little doubt it was her insight of the human dynamics in the hostel which found him a role (Cohen, 1980).

After the war Clare continued for a short time to work with Donald Winnicott in Oxfordshire but in 1946, after she had briefly worked with soldiers who had struggled as prisoners of war she joined the staff of the National Association of Mental Health in the education department to deal with implications of findings of the Curtis Committee. Perhaps it is not surprising when in 1947 offered the chance to return to the London School of Economics to establish and lead the first child care course in the United Kingdom, she took it (Holman, 1995). This course which was intended for all who had responsibility for children in care was set up following the report of the Curtis Committee. During her time in Oxfordshire Clare had become increasingly concerned in the quality and availability training for those involved in the welfare and care of children and young people and indeed she was called as a witness to the Curtis Committee on a number of occasions. Among other things, the report recommended that those involved in child care should have a better training. The new LSE course was one which integrated child development theory and child care practice and anticipated the need for an informed and qualified work force capable of running the new Children’s Departments which were to be established following the implementation of the 1948 Children’s Act. Over the years that it ran, the course enjoyed considerable esteem and was highly valued by its students (Holman,2001).

On her return to the LSE to lead the child care course she continued to benefit from the support of Donald and from time to time he taught on the course.

In 1949 Clare and Donald founded the Association of Child Care Officers Association which until 1970 was the principal organization for social workers concerned with the welfare of children. (Kanter, 2004)

Clare married Donald in 1951.

By the end of the 1940s Clare had developed an interest in psychoanalysis, and from the 1950s onward began her psychoanalytic training. Her analyst was Melanie Klein. She qualified as a psychoanalyst in 1960 (Kanter,2004).

The 1950s brought considerable discussion nationally about what form social work training should take and nowhere was the discussion and debate less lively than it was at the LSE. Clare, who had now become a nationally known figure in the social work arena, was of the school of thought which argued that training should be specialist and she wished to continue developing the specialist nature of her course which at that time had the backing of the Home Office. Others felt that a social work training should be a generic one and she was absent ill with meningitis when in 1957 the important decisions were being taken and her view was rejected (Donnison, 2000). The various social work courses at the LSE were amalgamated into a generic one and she lost not only the leadership of her course and the course itself. She continued to teach child care theory on the generic course but she remained disappointed by the decision (Holman, 2013).

The trend of child care legislation and policy was towards the ideal of a child care officer workforce in which all the members were fully qualified but by 1964 only 50% of social were ot the level of the course Clare taught on qualified and so Clare was encouraged to apply for the post of director of child care studies in the children’s department of the Home Office . She was appointed to the post and from 1964 to 1971 she succeeded in building strong training structure in cooperation with the then Central Committee for Education and Social Work (Cooper,1984 ) .

Also in 1964, she was persuaded to collect six of her papers for publication and these appeared in a monograph entitled Child Care and Social Work.(Kanter, 2004.)

Shortly before Donald died in 1971 her job at the Home Office was abolished but she returned again to the LSE as head of the Social Work Department, responsible for training the new profession of Social Workers, which had replaced the specialist training courses. Never happy with the generic course she left her post just after Donald died Three years later she was diagnosed as suffering from melanoma and although she left her post at the LSE she was still very much as a conferences speaker, she continued to write papers, and she kept up her clinical work. She also spent time editing her husband’s unpublished papers.(Winnicott, C.,1984).

Clare died in 1984.

Clare Winnicott’s influence on residential child care.

Helping adults to be adult

Clare Winnicott remained interested in residential work throughout her career but I wanted to concentrate on two instances of her work in Oxfordshire during the war. It is my view that in this stage of her career, though she was never a residential child care worker, she provided ways of thinking about the dynamics of residential child care that remain fundamental to its practice.

Let’s consider a celebrated Clair Britton episode when she first met Donald Winnicott. Here she is speaking to Alan Cohen as she recollects a task her then boss set her as he told her about Doctor Winnicott :

“There’s a difficult doctor working in that area. He comes down once a week. He doesn’t believe in social work because he likes to do it all himself. But it’s really in quite a mess as he is only there once a week. The staff are confused and you must go and see what is needed.” That’s what I was told. So I did. I turned up one Friday to the hostel where he was visiting, and listened, wondering where I could come in and what I could do in this situation. And I think one of the things that I did achieve, fairly soon, was to help the staff in the hostels to make use of his expertise, his knowledge, in a way that they were not able to do. They used to say “He comes down and talks to the children. He plays his pipe to them and we like him very much, but he doesn’t ever tell us what to do.” So I said “Well let’s never ask him what to do. Let’s do the best we can in the present situation and then when he comes again tell him what we did and see if he’s got any comment to make on it, and if we can therefore learn something from what we did. ”And that’s how it really evolved. ” (Cohen,1980).

It seems to me the insight Clare had in this situation was the significance she placed on not confirming the other person’s sense of his or her own feelings of inadequacy. Equally because the feeling was real for the other person, it was vital too, that Clare did not deny their feelings. What she did was find a modus operandi which allowed members of a confused staff group and a confused psychiatrist to find a role for themselves that they could accept and that made sense to them. In this way they felt safe and contained. She helped the people involved find another way to think and to feel about a situation which in turn allowed them to start finding a way through the confusion. The staff in the hostel were clearly struggling with the way the children were acting out their distress. They did not feel they knew what to do and of course wanted ‘the expert Winnicott’ to spell out the remedy. He had none and this was his despair both for himself and the staff. Clare helped the staff – and in a very real sense this included herself – to see that they could use Winnicott, not to ask him for remedies but to listen to his interest in what they did, and, in what they had to say, as well as to listen and think about the questions he asked. For the first time they had been given permission to reflect on their predicament and so rather than feeling panicked by fraught situations they were encouraged to trust that what they did when situations were tense, and that, if necessary, it was permissible to find time to think about things when they went wrong. In doing this they could make the children feel safer because, as the children expressed their suffering by acting out the trauma and anxieties created by their experience of separation and loss, they the staff could allow themselves to remain reasonably healthy adults and did not need to act out their anxieties. This would inevitably provide the children with greater security. Clare had helped all the adults including Donald Winnicott to become grown up again. She permitted the thoughts that it need not be significant if adults make mistakes in a setting like the hostel ; indeed it can be therapeutically helpful if adults do, as long as the mistakes are discussed and worked through by everyone involved, both children and adults, so that everyone can make more sense of what has happened. In this way even a bad experience can, in the final analysis, become a good one. If this happens adults remain adults, the children learn something that will nourish them in the future, and they will feel safe.

A job that is a necessary act of love

Another aspect of Clare Britton, the child care officer supporting a residential hostel for children was her understanding of what was necessary to let others know that your concern for them was committed and deep. She did this by demonstrating a capacity to work very hard and her understanding that child care work in any form could not be confined by routine working hours and this is, for many of us working in, say, a 40 hour a week mental straitjacket, an uncomfortable truth which Clare Britton, by her example and not her admonition makes us face. Love and care do not fit into neat timetables. She herself would work all hours to support a child and his family because that was what was needed. (Kanter, 2004).

In the field of residential child care I think only the best therapeutic communities for children have taken this on board and accepted that what they are engaged with is not a job but a necessary act of love. In many cases it is difficult to see how those of us who work in this field can avoid this conclusion. We may not be able to come to a satisfactory (for the children, that is) conclusion when we think of this but we should be honest about our limitations, and acknowledge openly they do not help the long term prospects of troubled children.

I wanted also to consider another well known anecdote from the Clare Britton annals. It is about a residential nursery which she talked about in her interview with Alan Cohen.

Yes, I was asked to go and visit a nursery. I had a lucky turn in the nursery. A stroke of luck happened to me that really established my credibility in the sight of the authority more than anything else. I was asked to go and visit a nursery and the Deputy Medical Officer, a woman, said she would take me to the nursery. All the children in the nursery were bedwetting and they were very concerned about it. So I remember being driven there and I was absolutely panic stricken! When her car stopped at the traffic lights I wanted to get out, and run, but we got there. And I just had to think to myself “Look, you don’t have to know the answer to this lot. All you have to do is to sit and find out what’s going on and relax.” So in fact this is what I did. I took out my notebook and really wrote down the daily timetable ‑. I said to the matron “Tell me what happens in the nursery from the time you wake the kids up in the morning. Who does it, and what happens all through the day?” And I wrote it down hour by hour by hour. And even she at the end of this performance said “Well they don’t get much time to themselves do they?” And I said “It does look like it.” I didn’t make any specific suggestions except to say “When do they play? When can they get messy? Do they have a time when they can get messy?” In fact they didn’t, they were always permanently cleaned up. And if they got messy they were cleaned up and sat down and not allowed to move again. But she really saw that herself by the end of the afternoon. I didn’t press it home. I came away from the nursery and of course never heard another word about it for a long time. So I rang up the Deputy Medical Officer and said “Look, what did happen? Is that nursery still in trouble? Do you want any more help?” “Oh no, no. It’s all cleared up. The bedwetting cleared up and none of us can think how you did it. And I can’t believe you’ve only had a year’s training”, she added.

(Cohen, 1980)

This vignette provides an example of Clare’s therapeutic insight and it shows the unconscious at work. It is not pedagogic. No lesson is administered. A process operates in which knotted emotional issues are given space to unravel, allowing anxieties to be released and this is achieved by listening and acknowledging a situation. It also demonstrates what might almost be described as a therapeutic law of the group living environment : what is presented as the main problem the group faces is often a mask hiding another underlying issue that is troubling the group (See Bion,1961).

In this nursery there waa a great deal of bedwetting and the staff in their anxiety believe it must be to do with them. In part they have decided they have caused all the toddlers’ troubles. The staff group has the notion that it is not doing right by the children. There seems to be a denial that the bedwetting may be due to the anxieties and fears these small children, evacuated from their family homes, may be feeling about abandonment and about loss. To assuage their bad feelings the nursery staff make an enormous effort to do do well for the children by keeping the children busily occupied, washed and tidy and there is as Clare Winnicott hints, no time for the children to be, to ruminate, to play at ease and no space to process the unhappiness they feel. Many years later the psychoanalyst Margot Waddell suggested that a trouble for social workers and child care workers is that their training and management regimes propel them towards being seen to be doing something for a child, when in fact there is a need to let things be so that changes can be digested and absorbed in tranquility rather than frenzy.

Clare treated this in an understated way by acknowledging the anxiety the staff felt but rather than telling them directly, she asked them to consider if they and the children were, in a sense working and trying too hard and that they did not give themselves – children and adults enough time to play. This as subsequent events showed released staff anxieties and, no doubt, the children’s too.

No doubt other and contrary interpretations of these two events might be made but I think reflection on these two stories might be helpful for those looking after children in a residential child care setting show how subtle the role of the adults in a group living environment for children. In residential work with children there are few strictly followed laws or rules to achieve specific outcomes or goals, but the adults should have an awareness, as they experience with the children the unique situations which develop in the daily life of a children’s home, of the opportunities these afford for both adults and children to gain new insights.

More than anything these two accounts demonstrate Clare psychodynamic roots. Nothing stays the same for the individual or for the group. As in our wider human community, life is a dynamic process. Resolution of one matter leads to other dynamics. Making sense of this is in a sense what life is about.

Training, specialist or generic?

The care and insight expected of a residential child care worker are in part different from those required of a number of other professional disciplines with a role in the upbringing and education of children who are not living with their own families. Clare Winnicott recognized this. She always valued her specific training as psychiatric social worker.

One of the recommendations of the Curtis Committee when its report was published in 1946 was that all workers with children should receive specialised training and become professionally qualified.

Clare Winnicott supported this and she as well her husband argued that there were children for whom residential child care was a first resort. Clare Winnicott supported the need for specialised training in child care and this is evidenced by the devastation she felt when the child care course she led at the LSE was closed and amalgamated into a generic course (Cohen, 1980). This is a cause she did not win and the history of the decades since the Curtis Committee. The current state of residential child care seems is a field where National Vocational Qualifications, cognitive behaviour therapy approaches, social pedagogy, and psychodynamically based therapeutic community approach all battle it out for the money. Ironically I am sure Clare Winnicott if she turned up today would not feel a stranger in the scene.

A last thought

There are so many more important avenues to walk down concerning Clare Britton/Winnicott. In this article I have merely peered down a few of them and I did not meet her. Still, over many years in many informal discussions at conferences I’ve been fortunate to meet with her former students, colleagues, supervisees and friends who all have said she was an impressive woman. She was conscientious. She always carried out what she promised to do, and pointed people in what usually turned out to be the right directions.

She was, they say, compassionate and I will finish with these words of Clare Winnicott’s which have always moved me.

“Acceptance goes very deep. It is not a passive thing, but an active effort on the part of the worker to know the individual as he is, as a person in his own right, with his own life to live, and his own intrinsic value as a human being. This does not mean that we accept or approve all that an individual does or says, but that we try to reach behind the delinquent act and the deceitful language to the suffering in the human being which causes the symptoms that we see. Acceptance in this sense is in itself a basic therapeutic experience. For one thing it is the opposite of rejection, but in a more positive way it implies to the individual a sense of value, of worth, which is essential to life.” (Winnicott,C. 1964, pp28-29)